As We See It

The lethal combo of socks, slippery floor and wall turned my forehead into a horror show. I didn’t cry, maybe because my brain had just thwacked my skull like a steak being tenderized. More likely, it was because I was going to see my Dad.

He’s not an ER doctor; he’s a radiologist, but the gash was superficial and he’s a suturing genius. The scar is almost invisible now, though it reminds me of that day and many others in a place most people avoid like the plague (unless they actually have the plague). I never felt hospital anxiety because it was my father’s world. And he was Superman.

Biases and hero complexes aside, he’s a good doctor. Most of the physicians who cared for me during my years in California, Idaho and Washington were good enough to inspire real trust. But when I moved to Las Vegas, the first thing I heard about health care was that joke about the airport. Unethical practitioners are frequently in the news. Friends have told stories about dubious charges, “extra” procedures and doctors who seem not to listen.

Over and over, I defended the profession. The system is undeniably flawed, as are people, but I couldn’t believe the care was as bad here as its reputation.

Then last week, I read of the arrest of a former chief of internal medicine for selling thousands of painkillers for many thousands of dollars, often in the hospital parking lot. Malpractice is one thing, but this is a joke.

Friends who work in the industry call Vegas medicine’s “Wild West.” That rep (and the city’s) makes it harder to attract physicians to practice here, and it’s reasonable to assume that pressing needs could impact standards. Given the associations our pleasure-centric economy has with behavior some might call reckless and indulgent, you have to wonder if it seeps into the greater professional culture.

Data can’t answer that, partly because ethics is a philosophical onion and partly because state medical boards have varying resources, autonomy, legal constraints and staff, and they resolve many cases internally, making it impossible to know how Nevada stacks up against Idaho for deeds that require serious discipline. Comparing them is “not useful,” according to the Federation of State Medical Boards, which compiles data from 70 boards nationwide. The numbers show trends within states, but they can’t reflect the whole picture.

I asked my Dad about the whole picture. He told me a true story about a town with five doctors. Four were outstanding. One wasn’t. Without context, hearing that 20 percent of a town’s doctors are bad might skew your reaction, but the fact remains that people died because of the individual behind the stat. Numbers stretch both ways. What we know—what we have always known—is that good guys and bad guys wear the same white coat.